Esophageal stretching or dilating is a procedure that is done when the Upper Esophageal Sphincter (UES) is not opening well, due to radiation treatment, muscle weakness, or other causes. When the UES does not open well, it makes it difficult to get foods to "go down" and can create a clogged or backed up pipe type of problem, frequently even resulting in vomiting during meals. There are simple exercises which have been shown to be effective in improving UES opening without having the esophagus stretched or dilated.
The Shaker exercise was developed by Reza Shaker, MD, who is a Gastro-Interologist. He developed this exercise to improve Upper Esophageal Sphincter (UES) opening through exercises instead of a surgical procedure. This exercise has been tested in well known, well accepted research studies and shown to be very effective.
All speech language pathologists learn about this exercise in graduate school as they are learning to help people with swallowing disorders. Yet, for some reason, speech language pathologists rarely ever receive referrals from physicians to treat this disorder with simple exercises. Instead, patients are usually referred to have their esophagus stretched or dilated, to get temporary relief, over and over, until they are told it can't be done anymore and then they are left to suffer with this disorder. They are never sent to the speech language pathologist, even when they have nothing else to offer them! Perhaps the referring physicians have not been made aware of current research on this topic.
In recent years, there have been new developments, making the Shaker exercise even easier to do and maybe even slightly more effective. Modern research has determined that this exercise, which is normally done by lying in a supine position and lifting your head up and down, can also be done sitting upright with resistance under your chin as you nod your head up and down. This is called the Chin Tuck Against Resistance (CTAR) exercise.
There are other exercises also which target the suprahyoid muscles, which can be helpful for this disorder. The suprahyoid muscles lift the larynx up and forward during the swallow, which is the movement that pulls the esophagus open. When the movement is stronger due to stronger suprahyoid muscles, the esophagus UES will open much better, in most cases. Simple exercises may well be equally effective, if not more effective in the long run, than esophageal stretching or esophageal dilating.
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About the Author: Jolie Parker, M.S.CCC-SLP is a speech language pathologist who specializes in the treatment of dysphagia. She is a co-inventor of the PhagiaFlex device for dysphagia, which has been clinically shown to strengthen the swallow, improve esophageal opening and laryngeal elevation, and widen the UES during the swallow.